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Special Needs Children
On February 1, 2020, the Illinois Department of Healthcare and Family Services (HFS) moved all children with special needs into managed care. The HealthChoice of Illinois Special Needs Children (SNC) program helps ensure that the best health outcomes are achieved and care gaps are decreased for special needs children.
Who is eligible?
Who is eligible?
SNC includes children:
Receiving Supplemental Security Income (SSI)
Enrolled in the Department of Specialized Care for Children Core Program
With physical disabilities
SNC excludes members who:
Use Medically Fragile/Technology Dependent (MFTD) waivers
Are part of the Nursing and Personal Care Services Program (NPCS)
Currently have commercial insurance
Special Needs Children are identified by the HFS. Children under the age of 21:
- Receiving Supplemental Security Income (SSI)
- Enrolled in the Division of Specialized Care (DSCC) Core program
- With a physical disability category of assistance
Youth Care membership is comprised of two populations:
- Youth In Care – Children who are currently under the guardianship of The Department of Children and Family Services
- Former Youth In Care –
- Children who have been adopted
- Are under a subsidized guardianship arrangement
- Have emancipated form DCFS and under the age of 21
- Have been reunited with their families in the previous 12 months
Our overall goal is to help manage the wellness of these children to where they can move to their personal optimal health status. Aetna Better Health of Illinois has been proactively finding interventions based on the needs of this specialized population.
Your call to action
To help give the most effective care to these members, we implore you to:
Work with our Specialized Care Coordination team
Aetna Better Health of Illinois created a team of licensed clinicians who are subject matter experts. They have extensive knowledge of physical, behavioral and social supports needed by children living with special health care needs. However, provider input is invaluable.
Review status as an Extended Provider Network
If there are any questions about network status, please call Aetna Member Services at 1-866-329-4701 (TTY: 711) for contract verification.
FAQs about special needs children
Currently, SNC identification isn’t available in the Medical Electronic Data Interchange (MEDI) system. Aetna Better Health of Illinois has raised this issue to HFS for follow-up. Until the issue is resolved, please:
Call the Aetna Member Services team to verify eligibility at 1-866-329-4701 (TTY: 711).
Yes. Children who are enrolled in MFTD and who receive NPCS will continue to be excluded from managed care.
If you have any questions about your network status, please call Aetna Member Services at 1-866-329-4701 (TTY: 711) for contract verification. You can also visit our “Find a Provider” page and download the Provider Directory to confirm if you’re in the network or not.
Physicians can start the contracting process by submitting an inquiry on our provider intake form. If you need assistance with the contracting process, you can email us. For general information on becoming a contracted physician, please visit the “Join our network” page.
Special Needs Children will receive all their Medicaid covered services and medical care coordination from the health plan.
Thank you for your ongoing commitment to these children, as well as your patience during the transitions.
If there are any escalated needs, please ask to speak with one of the SNC Leadership team members, or your Aetna Better Health of Illinois Provider Relations representative.